Claim total
$5,290.88
base $155.66 · payer covered $5,140.88
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-10-06
- Stop
- 2020-10-06
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-9689-0807060cb78e